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SPED*NET Wilton, and Temple Sholom of Greenwich, CT
Auditory Processing Disorders in Children: Mysteries and Misconceptions Lydia H. Soifer, Ph.D. Smart Kids with LD, SPED*NET Wilton, and Temple Sholom of Greenwich, CT March 2, 2017 ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Worksheet Questions 1. Where is the person in relation to the animal? 2. What direction is the animal facing? 3. Where in the United States might you see this? 4. What others things would you expect to see in the landscape? 5. Write a story about the picture. ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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A = cowboy’s hat; B= horse’s head; C = horse’s tail
©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Classroom Language Dynamics
©2017 Lydia H. Soifer, Ph.D. All Rights Reserved. Classroom Language Dynamics
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Auditory processing is…
The efficiency and effectiveness with which the CNS utilizes auditory information. The skills used include: Sound localization and lateralization Auditory discrimination Dichotic listening Temporal processing ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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©2017 and Lydia H. Soifer, Ph.D. All Rights Reserved.
Very simply put… Auditory process is what we do with what we hear! Three essential levels of processing on a continuum of neurological involvement Discriminating the acoustic characteristics of the sound received Analysis of the linguistic-phonemic aspects of the signal Processing the meaning of language Very simply stated Auditory Processing is “what we do with what we hear” The overall processing of spoken language should be viewed as a continuum of neurological involvement. Processing has been broken down and described by Gail Richard an Jean Ferrer in the Differential Screening test for Processing (Linguisystems) and is described this way: There is an initial analysis of the auditory signal that discriminates the acoustic characteristics of the sound received, which involves the neurological transfer of the acoustic signal from the brain to the ear via the central auditory nervous system. This first level of processing is often referred to as CENTRAL AUDITORY PROCESSING. The next level of processing involves the analysis of the linguistic-phonemic aspects of an auditory signal, which requires an individual to understand the sound-symbol relationship of language. The third level of processing relies heavily on the meaning of language, which involves the ability to form pictures in the mind, ensuring comprehension of the auditory signal received. If one of these processes disturbs the signal, there will be a misrepresentation of what was said. The purpose of a Central Auditory Processing evaluation is to attempt to determine where, if at all, the signal’s processing is deficient. ©2017 and Lydia H. Soifer, Ph.D. All Rights Reserved.
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Effective Auditory Processing
Is associated with other higher-order cognitive-communicative skills including: Phonological processing Comprehension and interpretation of auditory information Memory for auditory information ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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What is an auditory processing disorder (APD)?
It depends! What did you mean by that? Terminology can be confusing Auditory processing disorder or, Central auditory processing disorder or, Language processing disorder or, Attention deficit disorder ? ASHA says…. ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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ASHA says… Auditory processing disorder (APD) is a deficit in the perceptual processing of auditory information in the CNS. APD can affect people from early youth through old age. APD is associated with difficulties in a variety of communication and learning processes. ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Nothing like a good controversy to confuse an issue…
APD or CAPD first emerged in 1960s Why can’t we get along? Definition, diagnosis, treatment and relationship to other language and learning difficulties still disputed Problem of paradoxical results What to treat and how Everybody knows somebody… ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Characteristics of APD in Technical Terms
Poor performance in one or more basic auditory behaviors or skills including: Sound localization and lateralization Auditory performance with competing or degraded signals Auditory discrimination Auditory pattern recognition Temporal aspects of audition ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Characteristics of APD in More General Terms
Normal hearing Difficulty understanding speech and language through the auditory channel Difficulty in any listening situation with less than optimal conditions (acoustic distortions) Reverberation Background noise Acoustic filtering Rapid speech Competing speech ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Often, children with APD may have some combination of…
Normal pure-tone hearing Inconsistent response to auditory stimuli Huh? You talkin’ to me? Difficulty with auditory localization Where’d that come from? Duck!! Difficulty with auditory discrimination The cat can’t whisper! Deficiencies in remembering phonemes and manipulating them Nat is a fat rat or was he a cat or maybe a bat? ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Difficulty understanding speech and language in the presence of noise
Bloomingdale’s versus Bergdorf’s Difficulty with auditory memory How many times do I have to repeat myself? Poor listening skills I’m confused. I don’t get it. Difficulty understanding rapid speech or dialect My grandma is from Brooklyn. Frequent requests for repetition What? ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Bottom line Auditory processing disorders are heterogenous
Affect different people in different ways Cannot be diagnosed in isolation Diagnosis and treatment require multi-disciplinary coordination and cooperation ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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ASHA also says… Because APD and learning are both complex and heterogeneous, “it is to be expected that a simple, one-to-one correspondence between deficits in fundamental, discrete auditory process and language, learning and related sequelae may be difficult, if not impossible to demonstrate.” American Speech Language and Hearing Association, Technical Report, 2005 ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Diagnosing APD: 5 Ws and an A
Who? A multi-disciplinary approach Language and Speech Pathologist Psychologist Audiologist What? Language concepts, phonological awareness, cognitive-linguistic and communication skills Cognitive levels, other aspects of processing, attention and executive functions, motivation Acuity, auditory discrimination, auditory pattern recognition, dichotic listening, monaural, low redundancy speech tests (speech in noise or at an altered rate) ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Diagnosing APD con’t When? How? Why?
After attentional problems have been ruled out Not before seven or eight Not if services are already helping How? Don’t start with APD evaluation. Look at the big picture first, i.e., language, communication and cognition Why? To determine the areas of need for intervention ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Diagnosing APD: An Alert
A rose is a rose is a rose, or is it? Beware of tests that call themselves “auditory processing assessments” Many are language processing tests! ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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What to do?! What to Do?! Modify the environment
Compensatory training in auditory skills* Cognitive training and language therapy ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Modify the Environment
FM systems Personal Environmental Preferential seating Listening “buddies” Creating quieter classrooms Teacher training What we say and how we say it ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Compensatory Training in Auditory Skills
Compensatory Training in Auditory Skills* (You need a good language therapist) Speech sound discrimination Phonemic synthesis Auditory memory strategies Prosody training Localization training * Beware of attractive but unproven treatments ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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Cognitive and Language Training (You need a great language therapist)
Organizational skills Following directions Self-monitoring strategies Comprehension monitoring strategies Listening strategies Stabilizing knowledge and use of language rules ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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SPED*NET Wilton, and Temple Sholom of Greenwich, CT
Auditory Processing Disorders in Children: Mysteries and Misconceptions Lydia H. Soifer, Ph.D. Smart Kids with LD, SPED*NET Wilton, and Temple Sholom of Greenwich, CT March 2, 2017 ©2017 Lydia H. Soifer, Ph.D. All Rights Reserved.
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